Jove
Visualize
Contact Us
JoVE
x logofacebook logolinkedin logoyoutube logo
ABOUT JoVE
OverviewLeadershipBlogJoVE Help Center
AUTHORS
Publishing ProcessEditorial BoardScope & PoliciesPeer ReviewFAQSubmit
LIBRARIANS
TestimonialsSubscriptionsAccessResourcesLibrary Advisory BoardFAQ
RESEARCH
JoVE JournalMethods CollectionsJoVE Encyclopedia of ExperimentsArchive
EDUCATION
JoVE CoreJoVE BusinessJoVE Science EducationJoVE Lab ManualFaculty Resource CenterFaculty Site
Terms & Conditions of Use
Privacy Policy
Policies

Related Concept Videos

Aneurysm I: Introduction01:30

Aneurysm I: Introduction

An aortic aneurysm is a localized outpouching or dilation at a weak point in the artery wall. It may involve different parts of the aorta, such as the abdominal aorta, aortic arch, or thoracic aorta.Etiological factorsSeveral disorders are associated with aortic aneurysms.Congenital causes, such as primary connective tissue disorders like Marfan syndrome, impact the integrity and strength of connective tissues, notably affecting the aorta. Marfan syndrome is a genetic disorder that specifically...
Aneurysm III: Interprofessional Care01:26

Aneurysm III: Interprofessional Care

Aneurysm management involves either conservative medical therapy or surgical intervention, depending on the size and symptoms of the aneurysm. Conservative management is generally reserved for smaller, asymptomatic aneurysms, while larger or symptomatic aneurysms often necessitate surgical repair.Conservative Medical TherapyFor small, asymptomatic aneurysms, particularly abdominal aortic aneurysms (AAA) less than 5.5 centimeters in diameter, conservative medical therapy is recommended. This...
Increased Intracranial Pressure l: Introduction01:14

Increased Intracranial Pressure l: Introduction

Intracranial hypertension is a sustained elevation of intracranial pressure (ICP) above 22 mm Hg. In supine adults, normal ICP is ~7–15 mm Hg.The rigid, nonexpandable cranium contains three components—brain tissue, blood, and cerebrospinal fluid (CSF)—that total ~1,700 mL in a typical adult: 1,400 mL brain (~80%), 150 mL blood (~10%), and 150 mL CSF (~10%). According to the Monro–Kellie doctrine, total intracranial volume is effectively fixed. When one component expands, CSF and venous blood...
Increased Intracranial Pressure ll: Pathophysiology01:29

Increased Intracranial Pressure ll: Pathophysiology

Increased intracranial pressure (ICP) refers to a potentially life-threatening rise in pressure inside the skull. This usually happens when there is a major change in the volume of brain tissue, blood, or cerebrospinal fluid (CSF) — the three components inside the skull. According to the Monro-Kellie doctrine, if the volume of one component increases, the volumes of the other components must decrease to maintain normal pressure. If this does not happen, ICP rises.The process often begins with...
Aneurysm II: Clinical Manifestations and Diagnostic Studies01:21

Aneurysm II: Clinical Manifestations and Diagnostic Studies

Thoracic, aortic arch and abdominal aneurysms are significant vascular conditions that can present with various clinical manifestations and lead to serious complications. Understanding these manifestations and the appropriate diagnostic studies is essential for effective management and treatment.Thoracic Aortic AneurysmsThoracic aortic aneurysms often remain asymptomatic until they reach a size that impinges on adjacent structures. They typically cause deep, diffuse chest pain that radiates to...
Arteries of the Head and Neck01:26

Arteries of the Head and Neck

The human body's intricate network of arteries ensures that every organ system receives the necessary oxygen and nutrients for optimal function. The arterial network in the head and neck region is particularly complex, providing vital blood flow to the brain, eyes, and other critical structures. Prominent arteries in this region include the internal carotid arteries and the vertebral arteries.
The internal carotid arteries supply blood to the anterior portion of the cerebrum. They enter the...

You might also read

Related Articles

Articles linked to this work by shared authors, journal, and citation graph.

Sort by
Same author

Intracranial Atherosclerotic Disease Distribution Across Circle of Willis Segments: Insights from CREST-H.

AJNR. American journal of neuroradiology·2026
Same author

Impaired cerebral autoregulation in patients with moyamoya disease and moyamoya syndrome: A prospective cross-sectional study.

Clinical neurology and neurosurgery·2026
Same author

Inside the Heterogeneity of Primary CNS Vasculitis: A Single-Center 40-Year Experience.

Neurology(R) neuroimmunology & neuroinflammation·2026
Same author

Prospective untreated outcomes in patients with cerebral cavernous malformation.

Journal of neurosurgery·2026
Same author

GLP-1 Receptor Agonists for Secondary Prevention After Myocardial Infarction and Stroke in Type 2 Diabetes: Nationwide Real-World Evidence.

European journal of preventive cardiology·2026
Same author

A novel thermal comfort model for older adults - development and validation of the COMFA-OA model.

Building and environment·2025
Same journal

Isolated Cranial Tremors: A Reappraisal.

Seminars in neurology·2026
Same journal

Dystonia and Tremor.

Seminars in neurology·2026
Same journal

Pendular nystagmus and oculopalatal tremor.

Seminars in neurology·2026
Same journal

Sanjay Pandey, MBBS, MD, DNB, DM, FIAN, and Aasef Shaikh, MD, PhD.

Seminars in neurology·2026
Same journal

Tremor.

Seminars in neurology·2026
Same journal

Carotid Disease.

Seminars in neurology·2026
See all related articles

Related Experiment Video

Updated: Jun 5, 2026

Minimally Invasive Thumb-sized Pterional Craniotomy for Surgical Clip Ligation of Unruptured Anterior Circulation Aneurysms
11:58

Minimally Invasive Thumb-sized Pterional Craniotomy for Surgical Clip Ligation of Unruptured Anterior Circulation Aneurysms

Published on: August 11, 2015

Unruptured intracranial aneurysms.

Robert D Brown1

  • 1Mayo Clinic College of Medicine, Rochester, Minnesota 55905, USA. Brown@mayo.edu

Seminars in Neurology
|January 6, 2011
PubMed
Summary
This summary is machine-generated.

This review examines the clinical management of unruptured brain aneurysms. It evaluates the risks of leaving these lesions untreated versus the potential complications of surgical or endovascular interventions. The authors synthesize current data on aneurysm growth, rupture predictors, and the role of long-term monitoring.

Keywords:
subarachnoid hemorrhageneurosurgery outcomesvascular imaginganeurysm growth

Frequently Asked Questions

More Related Videos

A Murine Model of Carotid Aneurysm Formation
03:47

A Murine Model of Carotid Aneurysm Formation

Published on: September 9, 2025

Related Experiment Videos

Last Updated: Jun 5, 2026

Minimally Invasive Thumb-sized Pterional Craniotomy for Surgical Clip Ligation of Unruptured Anterior Circulation Aneurysms
11:58

Minimally Invasive Thumb-sized Pterional Craniotomy for Surgical Clip Ligation of Unruptured Anterior Circulation Aneurysms

Published on: August 11, 2015

A Murine Model of Carotid Aneurysm Formation
03:47

A Murine Model of Carotid Aneurysm Formation

Published on: September 9, 2025

Area of Science:

  • Vascular neurology and neurosurgery outcomes research within unruptured intracranial aneurysms medicine
  • Clinical epidemiology and diagnostic imaging analysis

Background:

Clinicians frequently encounter vascular dilations within the brain that have not yet caused bleeding. No prior work has resolved the optimal management strategy for every patient presenting with these incidental findings. It was already known that genetic factors and environmental triggers influence the development of these lesions. Prior research has shown that these abnormalities affect approximately two percent of the American population. That uncertainty drove the need to weigh the danger of rupture against surgical risks. This gap motivated a closer look at the natural progression of these vascular anomalies. Previous studies often struggled to balance individual patient profiles with population-level statistical trends. Understanding the long-term behavior of these lesions remains a primary challenge for modern neurovascular care.

Purpose Of The Study:

The aim of this article is to evaluate the clinical management strategies for patients diagnosed with unruptured intracranial aneurysms. The authors seek to clarify the complex decision-making process regarding whether to treat or observe these vascular lesions. This study addresses the significant challenge of balancing the natural history of the condition against the risks of surgical intervention. The researchers intend to synthesize current data on the likelihood of lesion growth and potential hemorrhage. This work investigates the role of intermittent imaging as a primary tool for conservative management. The authors aim to identify the key predictors that influence clinical outcomes for affected individuals. This review provides a comprehensive overview of the current evidence base for neurovascular practitioners. The study seeks to improve patient care by outlining the factors that necessitate either active treatment or ongoing surveillance.

Main Methods:

Review approach involved a systematic synthesis of existing clinical data regarding vascular anomalies. The authors examined longitudinal studies to characterize the natural progression of these brain lesions. Review approach utilized statistical evidence from population-based cohorts to assess rupture rates. The investigators evaluated procedural safety by analyzing morbidity and mortality metrics from various neurosurgical interventions. Review approach incorporated literature on predictive factors for lesion expansion and hemorrhage. The team assessed the efficacy of intermittent monitoring protocols through a comprehensive survey of published clinical outcomes. Review approach focused on comparing conservative management strategies against active surgical or endovascular treatments. The authors synthesized findings to provide a clear overview of current clinical decision-making frameworks.

Main Results:

Key findings from the literature indicate that these vascular dilations occur in approximately two percent of the United States population. Key findings from the literature suggest that the risk of rupture must be weighed against the potential for procedure-associated morbidity. Key findings from the literature reveal that most of these lesions are identified incidentally during brain scans performed for unrelated conditions. Key findings from the literature highlight that the decision to intervene is complex and highly dependent on individual patient characteristics. Key findings from the literature show that conservative management often involves periodic imaging to track potential changes in lesion size. Key findings from the literature demonstrate that the natural history of these anomalies is a critical factor in determining long-term prognosis. Key findings from the literature suggest that predictors of hemorrhage are essential for guiding therapeutic choices. Key findings from the literature indicate that the likelihood of growth remains a central concern for patients managed without surgical intervention.

Conclusions:

The authors synthesize evidence suggesting that clinical decisions must balance rupture risk against intervention-related morbidity. Synthesis and implications indicate that conservative management requires careful, periodic monitoring through standardized imaging protocols. The researchers propose that patient-specific factors influence the likelihood of lesion expansion over time. Reviewing existing literature highlights that procedural safety profiles vary significantly across different clinical settings. The authors emphasize that the decision to treat remains highly individualized based on anatomical and physiological characteristics. Synthesis and implications suggest that future care strategies should prioritize identifying high-risk markers for hemorrhage. The evidence confirms that untreated lesions necessitate ongoing surveillance to mitigate potential adverse outcomes. The authors conclude that comprehensive risk assessment is vital for determining the most appropriate therapeutic path for each individual.

The researchers propose that the decision relies on comparing the natural history of the lesion against the morbidity and mortality risks of surgical intervention. This balance determines whether active treatment or conservative observation is safer for the patient.

The authors identify repeat imaging as a key tool for monitoring patients who do not undergo immediate surgical procedures. This approach allows clinicians to track potential growth or changes in the lesion over time.

The authors state that periodic surveillance is necessary to detect potential growth or changes in the lesion. This monitoring helps clinicians assess the risk of hemorrhage in patients who are not candidates for immediate intervention.

The authors utilize longitudinal imaging data to evaluate the natural history of the lesions. This information helps determine the likelihood of future growth and the associated risks of rupture.

The researchers examine the phenomenon of aneurysm growth as a predictor for potential rupture. They compare this to the procedural risks associated with surgical or endovascular repair.

The authors imply that clinical management must remain highly individualized. They suggest that standardized protocols should incorporate specific patient markers to improve outcomes for those with unruptured vascular lesions.